论文部分内容阅读
目的:观察中医综合疗法治疗带状疱疹(HZ)急性期的疗效及对后遗神经痛的影响。方法:将120例患者随机按数字法分为对照组和观察组各60例。对照组采用西医常规治疗:泛昔洛韦片,0.25 g/次,3次/d,口服;维生素B1片,10mg/次,3次/d,口服;甲钴胺片,0.5 mg/次,3次/d,口服,阿昔洛韦软膏,外涂,2~3次/d。观察组采用中医综合疗法:抗毒消痛方,1剂/d,丁香膏外敷,2~3次/d,针灸围针刺,1次/d,两组疗程均为14 d。记录疱疹止疱时间、结痂和脱痂时间;采用视觉模拟(VAS)法评价患者疼痛情况,记录皮损评分,检测治疗前后T细胞亚群和血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平,随访3个月记录后遗神经痛(PHN)发生例数。结果:观察组总有效率95.0%,优于对照组的83.3%(P<0.05);观察组止疱时间、结痴时间(结痴面积超过50%)及脱痂时间均低于对照组(P<0.01);治疗后第7,14天,观察组VAS评分及皮损评分均低于对照组(P<0.01);治疗后观察组CD3、CD4及CD4/CD8水平高于对照组,CD8低于对照组(P<0.05或P<0.01);治疗后观察组外周血TNF-α,IL-6,IL-10水平低于对照组(P<0.01);进行3个月的随访,对照组有37例(61.7%)出现PHN,观察组有23例(38.3%),观察组PHN发生率低于对照组(P<0.05)。结论:中医综合疗法能减轻HZ患者疼痛,快速减轻皮损症状,促进疱疹愈合,减少PHN的发生率,临床疗效显著;中医综合疗法能调节T淋巴细胞亚群功能,提高免疫力,还能降低外周血TNF-α,IL-6,IL-10水平,减轻炎性损伤。
Objective: To observe the curative effect of traditional Chinese medicine (TCM) combined therapy on acute herpes zoster (HZ) and its effect on post-nociceptive neuralgia. Methods: 120 patients were randomly divided into control group and observation group by digital method in 60 cases. The patients in the control group were treated with conventional western medicine: famciclovir tablets, 0.25g / time, 3 times / d orally; vitamin B1 tablets, 10mg / time, d, oral, acyclovir ointment, topical, 2 to 3 times / d. Observation group using traditional Chinese medicine: anti-drug Qiaotong Fang, 1 / d, clove cream topical application, 2 to 3 times / d, acupuncture around the acupuncture, 1 / d, the two courses were 14 d. The herpes blistering time, scabbing and scabbing time were recorded. Visual acuity (VAS) was used to evaluate the patient’s pain. The skin lesion score was recorded. T-cell subsets and serum tumor necrosis factor-α (TNF- Interleukin-6 (IL-6) and interleukin-10 (IL-10) levels were recorded. The incidence of post-nociceptive neuralgia (PHN) was recorded at 3 months follow-up. Results: The total effective rate in the observation group was 95.0%, which was significantly better than that in the control group (83.3%, P <0.05). The observation group had less blister time, knot-knot than 50% P <0.01). On the 7th and 14th day after treatment, VAS score and lesion score in the observation group were lower than those in the control group (P <0.01). After treatment, the levels of CD3, CD4 and CD4 / CD8 in the observation group were higher than those in the control group (P <0.05 or P <0.01). After treatment, the levels of TNF-α, IL-6 and IL-10 in the peripheral blood of the observation group were lower than those of the control group (P <0.01) PHN was observed in 37 cases (61.7%), 23 cases (38.3%) in observation group and PHN in observation group (P <0.05). Conclusion: The comprehensive treatment of traditional Chinese medicine can relieve pain in patients with HZ, rapidly reduce the symptoms of skin lesions, promote the healing of herpes and reduce the incidence of PHN, with significant clinical curative effect. The comprehensive treatment of traditional Chinese medicine can regulate the function of T lymphocyte subsets and improve the immunity, Peripheral blood TNF-α, IL-6, IL-10 levels, reduce inflammatory injury.